Kudo Takahiro, Arai Katsuhiro, Iwama Itaru, Hagiwara Shin-Ichiro, Ishige Takashi, Yokoyama Koji, Kakuta Fumihiko, Jimbo Keisuke, Kondou Hiroki, Takaki Yugo, Kurasawa Shingo, Fujikawa Hiroki, Koike Yuhki, Hirai Fumihito, Ashizuka Shinya, Watanabe Kenji, Shimizu Toshiaki, Hisamatsu Tadakazu
Department of Pediatrics, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Division of Gastroenterology, Center for Pediatric Inflammatory Bowel Disease, National Center for Child Health and Development, Tokyo, Japan.
J Gastroenterol. 2025 Jul 2. doi: 10.1007/s00535-025-02271-7.
Inflammatory bowel disease (IBD) can occur at any age. In pediatric patients, the disease may present with a broader range of symptoms and more severe course than in adults, due to ongoing growth and development. Therefore, pediatric IBD often exhibits an atypical clinical course and laboratory findings. It is essential to recognize differences in disease presentation, differential diagnoses, and evaluation strategies specific to children. The revised Porto criteria, proposed by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) in 2014, are widely used globally, including in Japan, for the diagnosis of pediatric IBD.
Despite the widespread use of these criteria, no formal diagnostic guidelines for pediatric IBD have been developed in Japan. We aimed to support future guideline development by summarizing important diagnostic considerations and clinical practices for pediatric IBD in Japan.
This review was developed based on relevant international diagnostic guidelines and the expert opinions of Japanese pediatric gastroenterologists. It outlines key clinical and laboratory evaluations, as well as current treatment and follow-up approaches.
We summarized recommended diagnostic tests and clinical points that require special attention in children with suspected IBD. The article reflects both global standards and domestic clinical experience.
Although this article does not provide formal diagnostic criteria or assess evidence levels, it offers accurate and practical information to guide physicians and patients in the diagnosis and management of pediatric IBD in Japan.
炎症性肠病(IBD)可发生于任何年龄。在儿科患者中,由于持续的生长发育,该疾病可能比成人表现出更广泛的症状和更严重的病程。因此,儿科IBD常表现出非典型的临床病程和实验室检查结果。认识到儿童疾病表现、鉴别诊断和评估策略的差异至关重要。欧洲儿科胃肠病、肝病和营养学会(ESPGHAN)于2014年提出的修订后的波尔图标准在全球广泛使用,包括在日本,用于儿科IBD的诊断。
尽管这些标准被广泛使用,但日本尚未制定正式的儿科IBD诊断指南。我们旨在通过总结日本儿科IBD重要的诊断考量和临床实践,为未来指南的制定提供支持。
本综述基于相关国际诊断指南和日本儿科胃肠病学家的专家意见编写。它概述了关键的临床和实验室评估,以及当前的治疗和随访方法。
我们总结了疑似IBD儿童推荐的诊断测试和需要特别关注的临床要点。本文既反映了全球标准,也体现了国内临床经验。
尽管本文未提供正式的诊断标准,也未评估证据水平,但它为指导日本儿科IBD的诊断和管理中的医生和患者提供了准确实用的信息。